Chairman Gray and other members of the Health Committee, thank you for the opportunity to testify today. My name is Jodi Kwarciany and I am a Health Policy Analyst at the DC Fiscal Policy Institute. DCFPI engages in research and public education on the fiscal and economic health of the District of Columbia, with a particular emphasis on policies that affect low- and moderate-income residents. I am also a member of the DC Home Visiting Council, and co-chair of the Home Visiting Council’s advocacy subcommittee.
I am here to voice my support for multiple provisions of B22-0350, the “Home Visiting Services Pilot Program Establishment Act of 2017,” and to thank the Council for their interest in the District’s home visiting services.
Home visiting programs in DC provide critical services to parents and children that help the whole family in both the short and long term. We know through decades of research that home visiting can promote healthy child development and academic success, improve health outcomes, and support families’ economic security. Moreover, previous research on evidence-based home visiting programs through the Maternal, Infant & Early Childhood Home Visiting Program or MIECHV, which is the District’s largest funder of home visiting services, found that every dollar invested in a program yielded a return of $1.89, in part through reduced social services spending.[1]
Despite such positive results, we know there is more work to be done around home visiting in the District to strengthen and support it, but we have yet to fully identify what these needs look like and what the solutions are. For these reasons, we are particularly supportive of the portions of the bill that would evaluate DC’s current programs and that would increase the capacity of home visiting providers.
The proposed feasibility study would help assess our home visiting programs, including outcomes and capacities, and will help determine future priorities and goals. While DCFPI does not yet have a position as to whether a “pay for success” approach is the best way to finance the expansion of home visiting in DC at present, we would welcome a rigorous evaluation of DC’s programs through the feasibility study and its potential for expanding them.
We are equally encouraged by the capacity-building grants and expansion of Help Me Grow as stipulated in this legislation. In 2015, home visiting programs had the capacity to serve just over 1,300 families, a fraction of the total need for DC’s home visiting services.[2] Although our home visiting programs and providers are of great quality, it can be difficult to stretch funding to cover costs beyond services and salaries. Additional funding that helps improve programs and services’ quality, cultural competency, professional learning and overall opportunities to succeed will in turn help serve more clients and give them the opportunity to succeed as well.
Furthermore, creating a centralized referral and intake system through Help Me Grow will help streamline processes for accessing early childhood services, including home visiting. It is DCFPI’s hope that as the District moves forward with expanding the capabilities of Help Me Grow through a centralized system, that we also look to examples from DC’s homeless services, where a coordinated entry system and no-wrong-door approach have greatly enhanced coordination among providers in determining available resources.
In closing, DCFPI is encouraged by multiple components of this bill, and we hope that the Council will continue looking to the Home Visiting Council as a resource as they move forward with relevant policy discussions and implementation. Lastly, we encourage a thoughtful assessment of home visiting in the District, where a broader discussion about the value of home visiting within the District’s early childhood services and supports can occur.
Thank you for your time, and I’m happy to take any questions.
[1] Cristina Novoa and Jamila Taylor, “Home Visiting Programs are vital for Maternal and Infant Health,” Center for American Progress, September 12, 2017, available at https://cdn.americanprogress.org/content/uploads/2017/09/11115136/MaternalHealth-brief.pdf.
[2] “Status Report on Home Visiting in the District of Columbia,” Office of the District of Columbia Auditor, March 23, 2017, available at http://www.dcauditor.org/sites/default/files/Home.Visiting.Final_.Report.3.23.17.pdf.
